| NPI | 1952379414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX G4903) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX G4903) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2015-08-13 |